An analysis of e-cigarette and polysubstance use patterns of adolescents in Bangkok, Thailand

INTRODUCTION The prevalence of adolescent e-cigarette use has increased markedly in recent years. Specifically, the prevalence of e-cigarette use over the past 30 days was higher than the prevalence of use of other tobacco products. However, there is no definitive data on e-cigarette use among adolescents, including a description of how e-cigarette use is part of a more widespread pattern of substance abuse. The objective of this study was to assess the prevalence of e-cigarette use in combination with tobacco, alcohol, or marijuana, and the risk of polysubstance use among a sample of Thai adolescents, analyzed by sociodemographic characteristics. METHODS Data were extracted from the Bangkok Behavioral Surveillance Survey (BBSS) cross-sectional survey conducted in 2019. The survey used self reports from a sample of adolescents aged 14-17 years in Bangkok (n=6167). Multinomial logistic regression was used to determine the status of poly drug use in combination with e-cigarettes. RESULTS In all, 6.8% of adolescents in this sample reported having used e-cigarettes in the last 30 days. Among the students who used e-cigarettes, the majority (72.0%) reported using other substances along with e-cigarettes, and alcohol was the most common addictive substance used in combination with e-cigarette use. The use of e-cigarettes only and e-cigarettes in combination with other addictive substances (compared to the non-e-cigarette group) tended to be higher among male students, having low academic achievement, having a friend who smokes, being persuaded by a close friend, having ever had sex (OR: 1.48-3.70), and having close friends who drink alcohol (vs none) (OR=3.26). CONCLUSIONS Polysubstance use is highly prevalent among adolescents who use e-cigarettes. There should be extensive screening for e-cigarette consumption, including use of other addictive substances, especially alcohol. Early and comprehensive prevention efforts to reduce the use of e-cigarettes and other addictive substances can have a huge impact on the health of the adolescent population.

Automated summary

Adolescents in Thailand have high prevalence of e-cigarette use, with a majority of users using other addictive substances like alcohol. Factors associated with e-cigarette use include being male, having low academic achievement, having smoking friends, being persuaded by close friends, having had sexual experience, and having close friends who drink alcohol. Extensive screening and prevention efforts for e-cigarette consumption and other addictive substances are important for adolescent health.